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Therapeutic services for the use of speech-generating devices (SGD), also known as voice-output communication aids (VOCA), are essential for individuals with communication impairments. These electronic devices are designed to produce synthetic or digital speech, enabling users to communicate effectively. The process involves a comprehensive evaluation by a speech-language pathologist (SLP), who assesses whether the existing programming of the speech-generating device aligns with the patient's current communication requirements. This evaluation takes into account any changes in the patient's communication abilities, which may arise from various factors such as evolving speech limitations, physical disabilities, or learning challenges. Based on this assessment, the SLP may proceed to reprogram or modify the device to ensure it adequately supports the patient's needs, thereby enhancing their ability to communicate and interact with others.
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The therapeutic services for the use of speech-generating devices are indicated for individuals who exhibit communication impairments due to various conditions. These may include:
The procedure for therapeutic services involving speech-generating devices includes several critical steps to ensure the device meets the user's needs effectively. These steps are as follows:
After the therapeutic services have been completed, the patient may require follow-up sessions to monitor the effectiveness of the modifications made to the speech-generating device. The SLP will assess the patient's ability to use the device and make any further adjustments as necessary. Additionally, ongoing support and training may be provided to the patient and their caregivers to ensure they are comfortable and proficient in using the device. This post-procedure care is vital for maximizing the benefits of the speech-generating device and enhancing the patient's overall communication experience.
| Short Descr | USE OF SPEECH DEVICE SERVICE | Medium Descr | THER SP-GENRATJ DEV PRGRMG&MODIFICAJ | Long Descr | Therapeutic services for the use of speech-generating device, including programming and modification | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 7 - Physical Therapy Service, for which Payment may not be Made | Multiple Procedures (51) | 5 - Special payment adjustment rules on the RVU practice expense component of multiple therapy service applies... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1F - Hearing and speech services | MUE | 1 | CCS Clinical Classification | 220 - Ophthalmologic and otologic diagnosis and treatment |
| GN | Services delivered under an outpatient speech language pathology plan of care | KX | Requirements specified in the medical policy have been met | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GT | Via interactive audio and video telecommunication systems | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | GO | Services delivered under an outpatient occupational therapy plan of care | GP | Services delivered under an outpatient physical therapy plan of care | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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